title: Diagnostic value of "bedside ultrasonography" and the "water bath technique" in distal forearm, wrist, and hand bone fractures.
abstract: Bedside ultrasonography (BUS) has been widely used in many emergency evaluations, but the technique was not thoroughly evaluated for use in adult fractures. The water bath technique (WBT) is a modality which overcomes some important limitations of using BUS in extremity fractures. The study aims to evaluate and compare diagnostic values of BUS and WBT. The sensitivity, specificity, positive and negative predictive values (PPV and NPV), positive and negative likelihood ratios (LR+ and LR-), and accuracy of BUS and WBT were calculated and compared by the McNemar chi-square test. BUS had the highest sensitivity, specificity, PPV, and LR+ in the distal forearm. The highest NPV and LR- of BUS were seen in phalangeal and wrist injuries, respectively. The WBT examination had the highest sensitivity in phalangeal injuries and the highest specificity, PPV, and LR+ in the distal forearm. The highest NPV and LR- of the WBT examination were seen in phalangeal and wrist injuries, respectively. The McNemar χ (2) values for the comparison of BUS and WBT indicate that the two techniques provide statistically different results. The ultrasound revealed excellent diagnostic values which make it a favorable alternative in evaluating upper extremity fractures in adults. The WBT provides even better results.
authors.affiliation: Trauma Research Center, Emergency Medicine Department, Baghiyatallah Hospital, Baghiyatallah University of Medical Sciences, Mulla Sadra, Vanak, Tehran, Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Javadzadeh
authors.forename: Amir
authors.initials: A
authors.lastname: Davoudi
authors.forename: Farnoush
authors.initials: F
authors.lastname: Davoudi
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Ghane
authors.forename: Hojatolla
authors.initials: H
authors.lastname: Khajepoor
authors.forename: Hasan
authors.initials: H
authors.lastname: Goodarzi
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Faraji
authors.forename: Sadrollah
authors.initials: S
authors.lastname: Mahmoudi
authors.forename: Somayeh Sadat
authors.initials: SS
authors.lastname: Shariat
authors.forename: Kazem
authors.initials: K
authors.lastname: Emami Meybodi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005543:Forearm Injuries / Q000000981:diagnostic imaging*; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006230:Hand Injuries / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014867:Water; D014954:Wrist Injuries / Q000000981:diagnostic imaging*
chemical_list: D014867:Water